Provider Demographics
NPI:1548289887
Name:BURKE, ELIZABETH KATHERINE (ARNP)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:KATHERINE
Last Name:BURKE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6496 32ND AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-2437
Mailing Address - Country:US
Mailing Address - Phone:727-553-7216
Mailing Address - Fax:727-893-6978
Practice Address - Street 1:700 6TH ST S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4815
Practice Address - Country:US
Practice Address - Phone:727-553-7216
Practice Address - Fax:727-893-6978
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP596132363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL216473OtherAMERIGROUP
FL28285OtherSTAYWELL/HEALTHEASE/WELLC
FL300422800Medicaid
FL300422800Medicaid
FLY8830ZMedicare UPIN